go back

Missouri rates for HCPCS Q4201

Matrion, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.37 / $352.28 / $785.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $77.61 / $91.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $187.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.78 / $71.78 / $76.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $96.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.81 / $120.56 / $335.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.23 / $79.23 / $1,274.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.62 / $115.62 / $142.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $94.88